Title: The Comparative Study of the Effect of Concomitantly Administered Ondansetron on Duration of Post Operative Analgesia of Tramadol Hydrochloride in Patients Undergoing Gynaecological Surgeries

Authors: Dr Ajith Kumar G, Dr Prabhash .R, Dr Baburaj .C

 DOI: https://dx.doi.org/10.18535/jmscr/v7i8.26

Abstract

Background and Aims: To determine the effect of concomitantly administered ondansetron on duration of post operative analgesia of tramadol hydrochloride in patients undergoing  gynarcological surgeries

To compare the incidence of post operative vomiting between Tramadol group and Tramadol-ondansetron group.

Methods: The study was approved by our Institution of Ethics Committee and all patients provided written informed consent.  Sixty patients in the age group of 25 to 65 years belonging to ASA physical status I and II were induded in a prospective double blind randomized study. All patients were scheduled for elective Gynaecological surgeries under subarachnoid block:

Results: The duration of analgesia in both groups were assessed with VAS pain score. Tramadol group had better mean duration of analgesia, 327 minutes than the concomitant group, 220 minutes p value < 0.001.

Conclusion: Is the post operative use of Tramadol cannot be recommended with ondansetron as the first choice of the antiemetic, because ondansetron reduces the analgesic power of Tramadol on post operative pain.

Keywords: Tramadol, ondansetron spinal anaesthesia.

References

  1. Brain Ready, Acute peri operative pain, Anaesthesia 5th edition RD Miller 2000; p. 2325.
  2. Carlc hag Jr. MD PhD. Clinical anaesthesiology, 3rd edition, G. Edward Morgan, Jr. MS Mikhail, MJ Mury. 2002; p. 344.
  3. Michal Errante, Acute post operative pain management, Principles and practice of Anaesthesiology, JH, ED. Longneckor, GE Morgen. 2nd P. 2347.
  4. S MoiedAhamed, RM Khan, S Banu, MH Siddiqui, AH Haq. Therapeutic suggestion under general anaesthesia reduce the incidence of post operative emesis. Ind. J. Anaeth (41) 1997; 158.
  5. Robert K Stoelting, Pharmacology and Physiology in Anaesthetic practice 3rd 1999. P. 103.
  6. MN Sadiq, PC Rath, N Pani. Efficany of Tramdaol hydrochloride as pre operative analgesia. Ind. J. Anaesthe. 42, 1998. P. 99.
  7. KL Tulsiani, Premila Malik, OP Garg Comparison between Tramadol hydrochloride and pentazocine lactate for post operative pain, Ind. J. Anaesthe. 41, 1997. P.44.
  8. Crighten IM, Martin PH, Hobbs GJ, Cobby TF, Fleteher, AJP, Steward PD. A comparison of the effects of intravenous Tramadol and morphine on gastric emptying in human volunteers. Analg 1998, 87:445-449.
  9. Olle Fortung G et al, Ketorlac Versus Tramadol comparative study of analgesic efficacy in the postoperative pain in abdominal hysterectomy. Rev. Esp. Anaesthesiol Reamin 2000. April 47 (4) 162-7 (Spanish).
  10. Sunshine A, Olson NZ, Zighelboiml, Decarto A, Minn FC, Analgesic oral efficacy of Tramadol hydrochloride in post operative pain. Clin Pharmacol Ther. 1992 June, 51.
  11. MH Pearman. Single dose intravenous Ondansetron in the prevention of post operative nausea and vomiting. Anaesthesia 1994 vol. 49. S011.
  12. De Witte JL, Schoemakers B, Sesseler DI, Deloof “The analgesia efficacy of Tramadol is impaired by concurrent administration of Ondansetron”, Anaesthesia Analgesia, 2001 Dec. 93,1626.
  13. Arcioni R, Della Rocca M, Romano S, Romano R, Pietropali P, Gasp aretoo, “Ondansetron inhibit the analgesic effects of tramadol. A possible 5HT3spinal Receptor involvement in Acute pain in humans”, Anaesthesia Analgesic, 2002 June, 1553-7.
  14. J Boome, HM Robb, N Ray, Y Girigis& G J Wardall “ The use of Tramadol following day case oral Surgery” Anaesthesia, March 1999, 28

Corresponding Author

Dr Prabhash .R

Associate Professor, Govt. Medical College, Manjeri